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Mech/Vent Unit 6

SPC Mechanical Ventilation Unit 6 Exam 4

What is Extrinsic WOB? ETT, settings, tubing, etc
What is Intrinsic WOB? Work needed to overcome the normal elastic resistive forces of the lung.
Ways to REDUCE WOB? 1. Use largest EET 2. Use PEEP/PSV 3. Correctly adjust sensitivity 4. Use Adequate flow rates (60-100 L/min) 5. Decrease RAW
Hypoventilation leads to acidosis or alkalosis? Acidosis
With Hypoventilation an increase in K (Potassium) will lead to what followed by what? Hyperkalemia then Cardiac Dysrhythmias
Hypoventilation can cause an increase in ICP from what and what? Vasodilation and increased Cerebral Perfusion
During Hypoventilation Renal Compensation takes how long? 18-36 hours
Hyperventilation leads to acidosis or alkalosis? Alkalosis
Hypoventilation is a left or right shift in O2 Dissociation Curve? Right
Hyperventilation is a left or right shift in O2 Dissociation Curve? Left
Hypoventilation in reference to the O2 Diss. Curve leads to what? Decrease in Hemoglobin to carry O2
Hyperventilation in reference to the O2 Diss. Curve leads to what? O2 Less available at tissue level
With Hyperventilation a decrease in K (Potassium) will lead to what followed by what? Hypokalemia then Cardiac Dysrhythmias
Hyperventilation can lead to decrease in what? Cerebral Perfusion
T/F It is difficult to wean a patient who is hyperventilating? True
Increase MAP leads to a decrease in what and what? Decrease Venous Return & C.O.
If MAP are kept to a minimum then there will be what? Less Hemodynamic Compromise
Normal MAP =? 0
MAP can be kept lower by changes in what? I:E ratio, PEEP, SIMV, Inspiratory gas flow and pattern
Definition of MAP? Average airway pressure throughout ventilator cycle
MAP is affected by what? Rate, I-Time, Flow, Pressure, or PEEP
If MAP is above 12 cmH2O it increases risk of what? Barotrauma
Effects of ABG on Renal Function: PaCO2 >65mmHg decrease Renal Function
Effects of ABG on Renal Function: PaO2 Renal function disease w/ decrease PaO2 due to vasoconstriction. (Below 40mmHg is (severe hypoxemia) kidney function dramatically decreases.
What are the complications associated with Auto-PEEP? 1. Barotrauma 2. Tension Pneumothorax 3. Circulatory Depression 4. Increased WOB
What are some Ventilator Associated Lung Injury (VALI)? 1. VAPS 2. O2 toxicity 3. ARDS 4. Barotrauma (pneumothorax, pneumomediastinum, subcutaneous emphysema 5. Over distention of the lung 6. Collapse of the alveolar units
What FIO2 timing risks are associated with O2 Therapy with Ventilator? 1. FIO2 >60% for more than 48 hours 2. FIO2 of 100% can cause change in 6 hours
Hazards of O2 Therapy associated w/ Mechanical Ventilation? 1. Decrease in compliance 2. Decrease in surfactant production 3. Decrease tracheal mucus flow 4. Capillary injury 5. Endothelial cell damage and accompanying increased lung water 6. Progressive formation of absorption atelectasis 7. Lead to ARDS
VILI occurs at the what? Acinus
VILI is caused specifically by what? Ventilating with high positive pressures and/or volumes.
VILI at the acinus can lead to what? 1. Altered lung fluid balance 2. Increased endothelial and epithelial permeability 3. Severe tissue damage
Alveolar Instability occurs in what? 1. ARDS due to absent or altered surfactant and also with VILI
Opening and closing of alveoli can cause what? Milking out of surfactant and alveolar instability
What is barotrauma? Formation of extra-alveolar gas (i.e. subcutaneous emphysema, pneumothorax, pneumomediastinum, pneumoperitoneum and pneumopericardium).
What is the difference and end result of Barotrauma. Nothing end results are the same
Difference in Barotrauma & Volutrauma? Barotrauma is damage caused by excessive pressures where Volutrauma is damaged caused by excessive volumes.
What may predispose a patient to Barotrauma? 1. High Peak 2. Bullous lung disease 3. High PEEP w/ High VT 4. Aspiration of gastric acid 5. Necrotizing Pneumonias 6. ARDS
What is Subcutaneous Emphysema? 1. Generally related to the inadvertent introduction of air into tissues. 2. Can often be seen as a smooth bulging of the skin. 3. Palpation or feeling of the skin, produces an unusual crackling sensation as the gas is pushed through the tissue.
What is Pneumomediastinum? 1. Condition in which air is present in the mediastinum (the space in the chest between the two lungs). 2. May occur following perforation of the trachea, in association with pneumothorax, or with other diseases.
What is a Pneumothorax? A collection of air or gas in the pleural space, which surrounds the lungs.
What is Tension Pneumothorax? 1. Complete collapse of the lung which occurs when air enters but does not leave the space around the lungs (pleural space) 2. It is a potentially life-threatening condition which can lead to dangerously low O2 levels, shock, or death
Created by: Langhout1418